CBCT in orthodontics: the wave of future
Cone beam computed tomography (CBCT) has probably been one of the most revolutionary innovations in the field of dentistry in the past decade and it provides a novel platform for orthodontic diagnosis and treatment planning. Current imaging techniques are essentially two-dimensional (2D) representations of threedimensional (3D) objects and suffer from several limitations. Hence, fulfillment of ideal imaging goals has been limited. Twodimensional radiographs are insufficient, especially in complex cases like impacted teeth, supernumerary teeth and orthognathic surgeries. CBCT images provide far more detailed information than conventional 2D radiographs and are user friendly. Soft tissues, skull, airway and the dentition can be observed and measured on CBCT images in a 1:1 ratio.
CBCT provides an excellent tool for accurate diagnosis, more predictable treatment planning, more efficient patient management and education, improved treatment outcome and patient satisfaction. This article focuses on various applications of cone beam CT technology in orthodontics.
Available from: F. Jeremias
- "The applicability of such technique to dentistry is broad and has been increasingly employed as a complementary method for diagnosis of buccomaxillofacial pathologies and temporomandibular disorders as well as for localization of impact teeth, placement of implants, orthognathic/craniofacial surgeries, and orthodontic planning.Particularly in the case of impacted or supernumerary teeth removal, surgeons often operate adjacent to significant anatomical structures such as vessels, nerves, adjacent teeth roots, and paranasal sinuses.The diagnosis and treatment planning is facilitated with CBCT because images are accurate in determining the angulation and buccal palatal locationbeside eliminates image superimposition and allows tridimensional reconstruction and in different planes.Furthermore, CBCT images are also useful for determining the proximity of impacted tooth to the roots of adjacent teeth, as well as the degree of resorption,avoiding damages to the essential anatomical structures during surgical approach.Taking "
Available from: Giampietro Farronato
- "In conclusion, we have determined that the use of the computer for the tracings of the 3D radiographs obtains less measurement errors and overall much more precise cephalometric analyses. The 3D technique has thus several advantages when compared to the conventional technique such as a true representation of reality, a lesser risk of operator-dependent errors from occurring and absence of overlapping anatomical structures . However, to be able to confirm such results, further research is needed on a bigger sample. "
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ABSTRACT: In this study we aimed at quantifying the possible errors which may occur when assessing specific reference planes and linear derivants on cephalometric radiographs traced manually and digitally. Furthermore, we have compared the precision of the tracings according to both the two- and three-dimensional (2D and 3D respectively) techniques and between clinicians.
We have obtained via cone beam computed tomography (CBCT) archive of the orthodontics department of the University of Milan 20 cone beam CT radiographs from which we have obtained 20 latero-lateral radiographs. Five independent clinicians referred to as A, B, C, D, E have been randomly selected to trace both radiographs maintaining the same working and lighting conditions to minimize the possibility of operator- and environment-dependent errors from occurring. The results have been statistically assessed by Student's t test. The comparison of the data gathered from the tracings in 2D and 3D shows that certain measurements have statistically significant differences. Particularly, the difference in the measurements of the sagittal dimension of the mandible and the anterior and posterior nasal spines has resulted to be statistically significant. The results of the intra-operator comparison proved that the 3D technique is extremely precise.
Our study determines that the 3D technique allows to obtain more precise results and with several advantages when compared to the conventional technique such as a true representation of the anatomical structures, less risk of errors occurring due to clinician skills and absence of overlapping anatomical structures.
Available from: S. Kutalmış Büyük
- "CBCT has probably been one of the most revolutionary innovations in the field of dentistry in the past decade, and it provides a novel platform for imaging of maxillofacial area (28). It also provides clear and accurate images of structures, and therefore is extremely useful for assessing the bone component. "
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ABSTRACT: Objectives: The aim of this study was to determine and compare the reliability to accomplish of common mandibular landmarks and to determine the incidence of incisive canals, anterior looping, and lingual foramina in children from panoramic and CBCT images.
Study Design: Panoramic and CBCT images from 100 children and adolescent patients were randomly selected. In order to grade the visibility of mandibular anatomical landmarks, a four-point rating scale was used.
Results: In panoramic images, the mandibular canal could be observed in 92.5% of cases, with good visibility in 12.0%. The mental foramen could be observed in 44.5% of cases, while none had good visibility. Anterior looping of the mental nerve was present in 16.5% of the cases, and none had good visibility. An incisive canal could be identified in 22.5% of cases, with only 1.5% showing good visibility. The lingual foramen could be visualized in 61.0% of cases, with good visibility in 6%. In CBCT images, the mandibular canal, the mental foramen, and the lingual foramen could be observed in 100% of the cases, with good visibility in 51.0%, 98.5%, and 45.0% of cases, respectively. Anterior looping of the mental nerve was present in 26% of cases, with 2% having good visibility. An incisive canal could be identified in 49.5% of cases, with only 75% showing good visibility.
Conclusions: This study confirms the applicability of CBCT images to visualize critical structures in children.
Key words:Panoramic radiography, cone beam computed tomography, anatomical landmark.
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